Glenn E Hunt Associate professor and principal research fellow, University of Sydney and Concord Centre for Mental Health, Concord Hospital, Concord, New South Wales, Australia

Deborah Koder and colleagues present the findings of a survey of the most common and distressing challenging behaviours encountered and the preferred ways of coping with them

Aim To identify the most common and distressing behavioural and psychological symptoms of dementia (BPSD) in nursing homes and to identify staff preferences regarding its behavioural management.

Method A descriptive cross-sectional survey was completed by a self-selected sample of 247 staff working in 21 nursing homes in a defined catchment area. The survey contained items relating to experience in aged care work, attitudes towards BPSD, ratings of the importance of certain behavioural strategies for managing BPSD, and the Challenging Behaviour Scale.

Results Shouting, wandering and restlessness had the highest incidence, frequency and difficulty ratings. Frequency of BPSD and level of satisfaction with how they were managed had the greatest effect on overall level of difficulty in managing behaviours. Staff rated discussing behavioural concerns at a group level and with senior nursing staff as the most important behavioural strategies.

Conclusion A strong relationship was found between frequency and difficulty of BPSD. Therefore, interventions targeted at lowering frequency of BPSD are recommended. Communication across a number of levels may enhance the implementation of behavioural interventions.